Q&A | One gutsy psychiatrist has spoken out about homosexuality, but social and professional pressure has silenced others

Over the years I've interviewed extraordinary individuals ranging from Newt Gingrich to Michael Jordan, but none matches Jeffrey Satinover in his range of intellectual attainments. Satinover was a National Merit Scholar as an MIT undergraduate and subsequently attained master's degrees at Harvard and Yale and a medical degree at the University of Texas. He practiced as a psychoanalyst and psychiatrist from 1976 to 2003. Last year, at age 61, he received a degree in physics (summa cum laude) from the University of Nice in France.

But Satinover also has an unusual attribute among intellectuals: courage. In 1996 he came out with Homosexuality and the Politics of Truth, which argued against the contemporary theory that homosexuality is innate and, in a sense, predestined. It's probably the best book on the subject, and it brought vicious attacks from the gay lobby. Even the Amazon.com website includes 70 customer reviews, with 33 readers giving it a five-star highest rating, 25 giving it a one-star lowest rating, and only 12 in the middle.

Positive reviews emphasize the book's careful research; hostiles complain, "Books such as these continue the myth that homosexuality is wrong-it is sad to think some people still believe this nonsense." Satinover, not backing down, has written amicus briefs on the question for Supreme Court cases. He also does physics research for a Swiss institute and teaches statistics.

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Q: Did you enjoy your years as a very busy psychiatrist?

I was always very curious and determined to pursue things that interested me. . . . If you are dealing with the question of homosexuality, particularly from the point of view of considering whether it's a changeable condition, then your life as a psychiatrist is guaranteed to be extremely interesting. It may not be comfortable, but you definitely won't be bored.

Q: As your life became interesting, did you develop a fan club?

I developed two clubs, the fan club and the club that wanted to club me to death.

Q: And at some point you became a public figure?

It was a slow process as I began to speak. I didn't just begin to develop a point of view about homosexuality and began to treat it as a reversible condition, but I also became upset at the bamboozlement about this whole topic that was prevalent in the mental health professions, and the propagation of a point of view that is at the very least debatable if not outright mistaken. I met so many remarkable individuals and discovered that homosexuality is not an easy thing to change. It goes to the very heart of one's relationships and becomes a completely dominant feature of one's life.

Q: Does homosexuality have to become the central identity?

Not everybody does that, but sexuality is the most important emotional bond that human beings have. Whenever that relationship becomes difficult, painful, disturbed, or altered, it's a source of enormous suffering. That's equally true for any heterosexual relationship. We need it, we crave it so much, and anything that is an obstacle becomes incredibly important. For those wrestling with homosexuality-that is, they feel a division between where their desires are leading them and what they most deeply want out of life-dealing with that successfully requires penetrating deeply into the heart of the relationship between men and women. People who do that must be willing to experience the suffering involved in confronting those issues, and often end up having a much deeper appreciation for the heart of human relationships. As a consequence of the price they paid, they are often very impressive human beings.

Q: You wanted to help them?

That they were being so badly mischaracterized by the mental health professions became a source of anger for me. I decided that I would write a book so that people out there struggling, attempting to help people, or dealing with public policy issues would have a resource. That propelled me into the public eye.

Q: How were homosexuals being mischaracterized?

They were told all sorts of things. People attempting to change were told, "You're not making this decision yourself, you're just internalizing the cruel ideas of the society around you," or, "You're a nutcase," "You're damaging society," on and on. There was very little support from that body of professionals that, in theory, ought to be their largest source of support. By the '90s, the dominant theory was that homosexuality was genetic, natural, and unchangeable.

Q: Was this backed up by any thorough research?

It was 95 percent ideology. Often, if I would give public talks on this subject, I would throw up overheads showing public statements of reporters and scientists all saying, "It's genetics, science shows this," etc. Then I would show quotations from the research articles that were being used to support these statements, and the research articles themselves contradicted these statements in the most flatly obvious way. Well-known researchers, whose work has been prominently cited as showing the genetic inheritance patterns of homosexuality, say in their own articles that they did the research to demonstrate that homosexuality was genetic. (That's already a problem because scientists aren't supposed to set out with an agenda, but at least they admit it.) And at the end of the articles they say, "We discovered, much to our surprise, that the environmental component is larger." Yet those very articles would be referenced in public policy debates as though they came to the opposite conclusion.

Q: Were you criticized on the basis of science, or were the attacks ad hominem, personal?

Almost completely ad hominem. An objective scientific debate would without question be overwhelmingly won by those who say that homosexuality is primarily environmentally determined.

Q: People with long experience working with patients know this, right?

Some do, but the knowledge is being lost. When it was considered kosher to treat homosexuality as a changeable condition, homosexuality was treated as potentially reversible. Not universally reversible-there's no such thing as 100 percent success in any kind of therapy-but a very significant success rate. Then it became increasingly politically incorrect to hold that point of view. We like to think of professionals as a cut above the man on the street in terms of their fiduciary responsibility and independence of thought, but sadly it's often the opposite. Professionals tend to be on average very influenced by social trends and fashions, especially if those fashions influence their ability to continue practicing and be a respected member of the community.

Q: We saw, with Proposition 8 in California, how people who made even a $100 contribution came under attack. So psychiatrists know that if they say what they think is true, they'll be harassed and attacked?

Yes. Activists have gone after professionals, particularly if they're relatively isolated, trying to suppress their freedom to speak or even to treat them. In the psychological professional associations, we have a number of times been within a hair's breadth of the associations making it an ethical violation for a therapist to help an individual change his sexuality, even if it's what the patient wants. (It has long been held in the psychotherapeutic professions that self-determination is a primary virtue, and you must respect what the patient wants. If you feel you can't do it or you don't want to help, that's fine, you recuse yourself, but you don't impose your point of view on the patient.)

Q: Would an ethical violation like that lead you to lose your license?

That's another step. An ethical violation might mean that you're excluded from participation in the professional society. If you feel you need the professional society-maybe for cost-effective malpractice insurance or other benefits, or it's just part of your identity-it's difficult for someone who isn't very independent to buck that trend. You have judges now depending on totally phony science, and nobody's out there calling these organizations to task. Other people know it, but they've been silenced.